CMS Tells Auditors To Reopen '2 Midnight' Claim Reviews

Law360, Washington (February 26, 2014, 8:06 PM EST) -- The Centers for Medicare and Medicaid Services on Monday issued updated guidance for its contract auditors reviewing inpatient claims under the controversial Medicare “two midnight” rule, saying all denials of claims made before February should be reopened to ensure they comply with recent rule clarifications.

With two guidances having been issued since the two-midnight rule was first announced in August — clarifying which claims are allowable under the rule — any so-called probe-and-educate audits done under the rule by Medicare Administrative Contractors for claims before Jan....